Stress Fractures

A stress fracture is a thin crack in the bone, and can be a common injury from high impact sports like running, basketball, or soccer due to an increase in activity. Stress fractures of the feet, ankles, and toes are very common, especially during the summer months.

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Most often, stress fractures occur when someone abruptly changes their activity level, such as trying a new sport or exercise, or by suddenly increasing the intensity of activity. This type of injury can be painful, but it is treatable! Look for these common symptoms of a stress fracture:

• Pain that lessens during rest
• Pain that gets worse with activity, such as walking
• Swelling or tenderness
• Bruising

The most important thing to remember if you suspect a stress fracture is to visit your podiatrist immediately for evaluation. Stress fractures, if left untreated, can easily lead to a complete fracture of the bone. Proper treatment of a stress fracture usually includes refraining from high impact activity, rest, ice, and elevation. Once the stress fracture is healed, it is important to follow your podiatrist's instructions completely to avoid recurrence of injury.

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Fungus, Fungus, Everywhere!

Unofficially, summer is here! This past Memorial Day weekend saw many of us hitting the pool, the beach, or running through the sprinklers. What do all of these classic summer activities have in common? They create the perfect environment for breeding bacteria and fungus!

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Foot and nail fungus is most common in the summer months because the increase in temperature and humidity creates an ideal breeding ground for this microscopic plant organism. Spending time in the pool or the locker room showers is an excellent way to pass these organisms around (athlete's foot for everyone!). 

Most people associate athlete's foot with itching, burning pain between the toes, but the chronic non-painful athlete's foot can be more dangerous. This form of infection, to the average person, looks like dry skin on the bottoms of the feet, but if you look closely you can see dry rings or circles on the surface. If left untreated, this form of athlete's foot can spread to your nails. A nail fungus generally presents as a thickened, discolored, brittle nail which can cause the nail to crumble or become painful. 

Don't despair, however. There are ways to prevent and treat fungal infections such as athlete's foot or nail fungus.

Prevention:

• Wash feet daily, paying special attention to between the toes. Make sure feet are completely dry after bathing or swimming.
• Wear shower shoes or flip flops when using a public pool, shower, or locker room.
• Wear clean, cotton socks. Steer clear of synthetic materials, and change them often!

Treatment:

• Left untreated, foot and nail fungus won't go away on its own It's important to seek treatment if you suspect you have a fungal infection.
• Your podiatrist may want to take a specimen to confirm a fungal diagnosis. This is generally a quick, painless procedure done in the office.
• Your podiatrist may prescribe a topical cream, an oral anti-fungal, or both to treat your infection.

If foot or nail fungus is putting a damper on your summer activities, make an appointment to see your podiatrist today!

Summertime, and the feet are stinky!

Most people believe that we sweat most profusely from our armpits; however, the foot has the highest density of sweat glands on the body! Each foot has more than 250,000 sweat glands, which can produce roughly a PINT of sweat per day, per foot!

As sweat is really only salt and water, it is not stinky in and of itself. But, in the heat of summer, your shoes can create a sauna effect and, when bacteria starts to flourish, foot odor can become a BIG problem! Don't despair, however. There are steps you can take the reduce that not-so-pleasant odor rising from your shoes at the most inopportune moments.

• Wear socks made out of breathable materials, such as cotton, and avoid synthetics, like polyester or nylon. Brands like Thorlo and Wigwam make socks specifically designed for ventilation.
• If you have especially sweaty feet, you may need to change your socks a few times a day.
• Try a special breathable shoe. Geox, Merrill, and most running shoes are designed specifically for ventilation, with a mesh upper.

Foot odor can also be caused by an underlying problem, such as athlete's foot. If you have embarrassing foot odor or sweaty feet, see your podiatrist today! There are various treatments that can have your feet smelling sweet this summer!

Exercise and Your Feet

It sounds obvious, but the feet are the foundation of the body. Many people underestimate how quickly foot pain can impact a person's ability to exercise. According to a 2014 APMA survey, one in four adults feel unable to exercise due to foot pain, and 39 percent of adults said they would exercise more if their feet didn't hurt (APMA News, April 2015 edition, pg. 12). Exercise is a vital part of maintaining a healthy lifestyle, and the benefits of regular exercise cannot be over-told. Weight loss is only a small part of what exercise can do for you; it can lower blood pressure and cholesterol, lead to better sleep and increased energy, and boost your mood.

What would you accomplish if your feet were pain free? If you experience foot pain and find yourself unable to exercise, make an appointment with a local podiatrist to be evaluated. You may think that nothing can be done, or may have gotten used to the nagging pain; however, a podiatrist can evaluate your specific problem and create a treatment plan specifically tailored to you. Check out the APMA's website for tips on maintaining healthy and active feet, and make an appointment with a podiatrist today!

If you are local to New Bern, please contact our office at 252-638-4700 to schedule an appointment.

A Parent's Guide to Foot Health for Athletic Kids

Millions of American children will participate in warm weather sports this year, from softball to soccer and swimming to cycling. No matter what their sport or whether they play competitively or just for fun, they will have one important thing in common: they'll need their feet to be pain-free if they're going to play their best and prevent injuries.

"Sports play a significant role in the lives of millions of young athletes," says Thomas Bobrowski, DPM, a podiatrist at Crystal Coast Podiatry, and a member of the American Podiatric Medical Association (APMA). "Parents need to be aware that sports, which require a substantial amount of running, turning, and contact, can translate to injuries. Protecting children's feet from injuries, and bringing them to a podiatrist when problems occur, can help keep kids in the game and make the sport more enjoyable."

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APMA offers some tips for helping protect children's feet while playing warm-weather sports:

• Protective taping of the ankles is often necessary to help prevent sprains or fractures.
• Buying a shoe designed for the specific sport your child plays not only improves your child's performance in the sport, but it also can help protect him or her from serious foot and ankle injuries. APMA has given its Seal of Acceptance to select sports footwear, which offer quality materials and protective support.
• Without the right sock, even the best athletic shoe won't score points- on the field or off. Athletic socks should consist of a natural/synthetic blend, which is best at wicking away moisture and minimizing foot odor. Socks should not have large seams that might cause blisters or irritation. Commonly played warm-weather sports and the risks associated with them include:
• Basketball - Children playing basketball may be at risk for ankle sprains, tendinitis, and plantar fasciitis (inflammation of the thick band of tissue on the sole of the foot). To minimize the risk of foot injury, choose a shoe with a thick, stiff sole, high ankle support, and shock absorption.
• Tennis - The rapid, repetitive lateral movements and shifting of weight required of tennis players can lead to injuries such as ankle sprains, plantar fasciitis, and corns or calluses. Tennis players will do best with a flexible-soled shoe that supports both sides of the foot.
• Running - Movements required of runners include leg extension and hitting the balls of the feet with a great deal of force. Running can lead to shin splints, heel pain, and blisters. A good running shoe should offer good support and shock absorption. In some cases, custom orthotics may be necessary to provide additional support and control of foot motion.
• Soccer - The running, jumping, and lateral movements required of soccer players can lead to many foot injuries, with heel pain and shin splints being among the most common. Soccer shoes should provide multiple cleats in the heel area and enough room for thicker socks.

"Sports-related foot and ankle injuries are on the rise as more children participate actively in sports," says Dr. Bobrowski. "Parents need to be vigilant to ensure children's feet remain healthy and safe. And remember- lack of complaint by a child is not a reliable sign that everything is fine. The bones of the growing feet are so flexible that they can be twisted and distorted without the child being aware of it."

Ensuring your child's feet stay healthy could go a long way - your young athlete could one day be the next LeBron James or Brandi Chastain. If your child participates in strenuous sports, monitor his or her foot health closely. If you suspect a problem, take your child to a podiatrist for evaluation and treatment.

Thomas Bobrowski, DPM is a podiatrist at Crystal Coast Podiatry in New Bern, NC. Call 252-638-4700 or visit www.crystalcoastpodiatry.com to make an appointment. Visit www.apma.org to learn more about foot health and care.

April is Foot Health Awareness Month!

April is Foot Health Awareness month! The American Podiatric Medical Association has introduced the "Play it Safe" campaign this month, focusing on "educating the public on podiatrists' expertise in the diagnosis and treatment of sports injuries affecting the lower extremities, their ability to provide guidance on proper athletic footwear, prescribe custom orthotics, and evaluate individuals' biomechanics." Follow our social media channels using the hashtag #PlayItSafe all month long for updates and valuable information!

The APMA has put together a special edition of their newsletter, Footprints, for the Spring season. It focuses on facts and myths surrounding athletic injuries. Check it out here!

How to keep your morning run healthy - for your feet!

Love isn't the only human experience that may make you wonder, "How can something so good hurt so bad?" You might find yourself asking that question after your morning run, afternoon power walk, or other physical activity that demands a lot from your feet. Physical activities like running, brisk walking, and playing sports can be great for your body; exercise improves cardiovascular health, burns calories, and builds muscle strength. Summer is a great time to stay - or get - active, but you still need to take precautions to ensure your exercise routine is also healthy for your feet.

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"Let's face it - we all have a lot riding on our feet, and we demand a great deal from them, especially when we're engaging in strenuous exercise," says Thomas Bobrowski, DPM, a podiatrist at Crystal Coast Podiatry and a member of the American Podiatric Medical Association (APMA). Foot health is a key component of overall health and well-being. Fortunately it's not difficult to take the right steps toward protecting your feet when you run, jog, power walk, or engage in other exercise.

"Be aware of common ailments of the season like athlete's foot, blisters, nail fungus, foot odor, and warts, and the summer foot fixes that can help cure them," says Dr. Bobrowski.

You can also take these steps to minimize the risk of injury or other problems when running or exercising:

• Stretch before and after activity. Lactic acid is the chemical by-product of exercise that causes muscles to ache after a workout. Stretching improves your circulation and decreases the buildup of lactic acid; it can also help relieve stiffness and prevent strain. Simply flexing the hamstrings and stretching calves, Achilles tendons, and shins can help ensure your workout is safe.
• Choose an appropriate running shoe. The only real expense of running or walking is buying shoes, so it pays to invest in a good pair that will provide the support you need to have a safe, successful workout. If you're prone to swollen feet later in the day, try on athletic shoes in the afternoon, when your feet are most swollen, to ensure a proper fit. Shoes should be stable from side to side, well-cushioned but with enough room to wiggle your toes, and snug to the heel. You can find a list of healthy footwear that carries APMA's Seal of Acceptance on the organizations website, www.apma.org/seal. 
• Be aware of the surface. The surface you're running on makes a difference in how hard the activity is on your feet. Hard, uneven ground can lead to stress fractures, slips, and falls. Softer ground is more foot-friendly and causes less shock than harder surfaces. If possible, run or walk on grass or dirt paths are flat, even, and well-manicured.
• Think twice about running in inclement weather. If your feet are wet and cold, the ground will feel harder, and you'll be more prone to slipping.
• Listen to your feet. It's not normal to experience pain or changes in the feet and ankles. If you experience foot pain that lasts for more than a few days, see a podiatrist for evaluation. He or she can tell you if the pain is a minor, passing problem or a symptom of something more serious such as injury or disease.

"With some simple precautions, you can ensure your walking and running activities remain healthy and enjoyable for your entire body, especially your hardworking feet," Dr. Bobrowski says.

Thomas Bobrowski, DPM, is a podiatrist at Crystal Coast Podiatry in New Bern, NC. Call 252-638-4700 or visit www.crystalcoastpodiatry.com to make an appointment. Visit www.apma.org to learn more about foot health and care. 

Plantar Fasciitis

Why are my heels so sore when I get out of bed in the morning or after driving home from work and getting out of my car?

These are a few of the most common questions I hear in the office from patients diagnosed with plantar fasciitis. This condition usually results from an overuse injury, as opposed to a traumatic acute injury. The plantar fascia is a very thick band of tissue which runs from the heel to the ball of the foot, acting as a strut beneath the arch. When you stand and walk, there is increased tension along this ligament, requiring it to stretch. If it is being stretched too much over a period of time, the ligament begins to weaken and tear. The initial symptoms are typically a deep bruised sensation along the bottom of the heel with your first few steps in the morning or upon standing after being seated for an extended period of time. As the condition progresses, the symptoms change to more of a sharp, burning pain lasting for a longer period of time throughout the day.

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The initial treatment focuses on proper support for the foot. GET RID of those beloved flip-flops, Sperry Top-Siders, and slippers. Refrain from going bare foot, even while at home. Begin wearing a running shoe as much as possible. Check out our blog post on choosing the proper running shoe here. Remember that any time you stand on your feet, you are stretching the plantar fascia. If it is already injured, you will continue to damage it without proper support; thus prolonging the healing process.

The second part of the treatment focuses on stretching the Achilles tendon, which when tight, translates into increased tension on the plantar fascia. You can perform this stretch against a counter or wall. Place your hands on the counter or the wall, keeping both feet flat on the floor with one leg in front of the other. Keeping the knee of the back leg straight and bending the knee of the front leg, slowly lunge forward until you feel a gentle pull along the back leg or knee. Hold this position for 60 seconds. Switch and stretch the other leg, performing two repetitions on each leg twice daily.

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The third part of the treatment focuses on massaging the plantar fascia to increase blood flow and accelerate healing. Heat the bottom of the foot with a heating pad or gel pack that can be heated in the microwave. Sit down and set the bottom of your foot on the source of heat for a minimum of five minutes. Remove the heat and begin massaging the bottom of the foot using a tennis ball, golf ball, or a soup can. Gently roll it back and forth through the arch of the foot for ten minutes.

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Stretching the Achilles tendon, massaging the plantar fascia, and wearing supportive running shoes daily can get you on the road to recovery. If the symptoms persist, contact a Podiatrist for evaluation and further treatment. 

A Solution for Ingrown Toenails

Do you often get ingrown toenails, and wonder if they are the result of improperly cutting them?

The answer is no; there are many reasons why you may develop an ingrown toenail, the most common of which is an inherited shape of the nail plate. Just as you inherit the color of your eyes and hair from your parents, you also inherit the shape of your nails. Nails can also change shape after an acute injury to the toe, from repetitive chronic shoe irritation, or after a fungal infection.

Once a nail is ingrown, it will not go back to it's original shape regardless of how many times you tear the edges out or cut a "V" in the center of the nail. Since the shape of the nail is determined by the shape of its matrix (root), there is no "bathroom surgery" that will permanently correct this problem. Many people are able to manage this condition with careful regular trimmings; however, the acute symptoms of pain, redness, swelling and drainage usually occur at the most inopportune time; before an important athletic event, dance recital or a vacation. This condition can become especially urgent for diabetic patients as it can lead to cellulitis (an infection spreading into the foot) if left untreated.

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The good news is, you do not have to suffer with this nagging condition for the rest of your life! There is a corrective procedure available that can permanently change the shape of the nail plate to prevent recurrence of ingrown toenails. This Permanent Nail Correction is typically an outpatient procedure, done in the office under local anesthesia, and it is a wonderful treatment option for patients suffering from chronic ingrown toenails. 

The procedure involves removing the offending nail border down to the level of the matrix and applying medication on the exposed matrix to prevent regrowth of that piece of the nail plate. The post-op care involves twice daily bandage changes for the first week, followed by daily bandage changes until the site is healed at about 2-3 weeks. Patients are usually able to resume their normal daily activities the following day, but may need to curtail exercise activities during the first week. A follow up appointment is scheduled at two weeks to evaluate the healing of the surgical site and to provide additional instructions.

If annoying and painful ingrown toenails are a common occurrence for you, consider discussing a Permanent Nail Correction with your podiatrist!

Does the Shoe Fit?

With the beginning of the New Year, many people are making resolutions to get healthier and exercise more frequently.  One of the most important things to be aware of when beginning an exercise regimen is how well your athletic shoes fit. Proper fitting shoes are vital to the health of your feet!

Athletic shoes should be replaced yearly, as support within the shoe is lost with frequent wearing. You should also choose the appropriate type of shoe based on what type of arch you have. Not sure? A great way to tell is the “wet foot test”.  By dipping your foot in a bucket of water and putting it down on concrete or paper, you will be able to see what type of arch you have, and this determines the type of athletic shoe that is best for you!

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Typically, a foot with a high arch will have a similar footprint to this. Notice the cut out where the arch is? That’s because it doesn't touch the ground when you put your foot down. You need extra support and cushion in that area to avoid foot pain!

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A neutral footprint will look similar to this. The curve for the arch is clearly defined, and this foot type can generally wear most types of shoes. Supports may still be useful to avoid foot pain.

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A foot with a low arch is typically referred to as a “flat foot” and will look similar to this. Notice how the arch is not clearly defined? Shoes with increased support and stability will minimize over-pronation (the foot rolling inwards due to lack of support) which can lead to injury and foot pain. 

Now that you know your foot shape, it's time to choose the athletic shoe that is best suited to it. Dr. Bobrowski has put together a list of shoes that are appropriate for each foot type! 

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After you've selected the appropriate athletic shoe for your foot type, it’s time to make sure they fit properly! The Journal of Foot & Ankle Surgery released a study that suggests that 35% of Americans underestimate their shoe size by a half size, and athletic shoes should be a half size bigger than your regular shoes.

Most shoe stores offer foot measurement when purchasing a pair of shoes. Make sure you are standing when being measured, as your foot is larger when standing. Shop for shoes in the afternoon or near the end of your day, when feet tend to be the largest.

Now that you have well fitting, supportive shoes, this can be the year you keep those awesome resolutions!

Written by: Ashley LaPorte

Reviewed by: Dr. Bobrowski